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Editorial |

Changing the Narrative for Early Childhood Investment

Jack P. Shonkoff, MD1
[+] Author Affiliations
1Center on the Developing Child, Harvard University, Cambridge, Massachusetts
JAMA Pediatr. 2014;168(2):105-106. doi:10.1001/jamapediatrics.2013.4212.
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Advances in the biological and social sciences tell us that the period from conception to school entry is a time of both significant opportunity and considerable risk. Multiple interventions during these early years have been designed to address the roots of lifelong disparities in learning, behavior, and health, and half a century of program evaluation has documented positive impacts on a variety of outcomes. That said, the quality of program implementation has been highly variable and the magnitude of the impacts has remained fairly stable during the past several decades, consistently falling within the small to moderate effect-size range. The time has now come for a different approach to early childhood investment that catalyzes innovation, seeks far greater impacts, and views best practices as a baseline, not a solution.1,2

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